Incidence of COVID-19 in an Italian cohort of patients with systemic lupus erythematosus: an observational survey. (Special Issue: Letter to editor rheumatology: commentaries and controversies.)

ABSTRACT

This article aimed to investigate the incidence of COVID-19 in patients with SLE followed at the Rheumatology Unit of the University of Campania, Italy. Out of them, the majority were females (249), with a median age of 47 years. Approximately 72% of patients were treated with HCQ (5 mg/kg/day), 37% with conventional synthetic disease-modifying drugs (47 mycophenolate, 37 azathioprine, 12 methotrexate, 4 cyclosporine, 1 colchicine), 15 patients were receiving biological agents (13 belimumab, 1 rituximab, and 1 abatacept), and more than half of the cohort were also taking corticosteroids (median dose 5 mg daily). A further 50 patients reported respiratory symptoms consistent with a viral infection, but they did not have access to the swab. These patients had a mild clinical course with a rapid resolution of symptoms. Serological test was performed in 2 patients with respiratory symptoms and was negative. No patients were admitted to hospital care and none reported a viral pneumonia. Even HCQ seems to not have a prophylactic role in the prevention of COVID-19 infection, as it has recently been shown by a randomised controlled trial, such conclusion cannot be drawn from this study which identified no confirmed cases of COVID-19. In conclusion, although they cannot exclude asymptomatic infections, the likely low incidence of COVID-19 in our SLE cohort could encourage the maintenance of ongoing rheumatological therapy. However, these are preliminary results that can only be regarded as tentative to help clinicians until replicated in larger cohorts.